Factors Associated with Primary Care Provider's Job Satisfaction and Organizational Commitment in China: A Machine Learning-Based Random Forest Analysis.

The objective of the study is to explore the factors that influence the job satisfaction and organizational commitment of primary care providers in China, with a focus on the impact of the COVID-19 pandemic and the rescission of restriction policies. We utilized the 20-item Minnesota Satisfaction Questionnaire (MSQ) and the 25-item organizational commitment survey to assess job satisfaction and organizational commitment. In total, 435 valid responses were included in our analysis. The average scores for job satisfaction and organizational commitment were 80.6 and 90.8. After a two-step tuning process, we built random forest models by machine learning. The results show income change, working years, working years in the current institute, and age were the four most important features associated with job satisfaction, organizational commitment, and most of their dimensions. The number of professional fields engaged, gender, job status, and types of endowment insurance were least associated. During pandemic time, income-related factors remain a core concern for primary care providers, whereas job security may lose its importance. These findings suggest that financial bonuses may be an effective way to boost morale, and age-specific motivation plans may be necessary.

Primary care provider's job satisfaction and organizational commitment after COVID-19 restrictions ended: A mixed-method study using a mediation model.

Objectives: More and more countries have decided to cancel most or even all COVD-19 restrictions. However, it is unclear how ending of restrictions will affect primary care providers' job satisfaction and organizational commitment. Our objectives are to explore the current status and possible change in primary care providers' job satisfaction and organizational commitment after massive restriction policies ended in China. Methods: This was a mixed-method study that utilized structured questionnaires and semi-structured qualitative individual interviews. The 20-item Minnesota Satisfaction Questionnaire (MSQ) and 25-item organizational commitment survey were adopted to assess job satisfaction and organization commitment. Descriptive statistics and mediation models, as well as inductive thematic analysis, were used to analyze quantitative and qualitative data. Results: A total of 18 interviews and 435 valid survey responses were included in our analysis. The average scores for job satisfaction and organizational commitment were 80.6 and 90.8. The thematic analysis revealed one major theme: ethical and moral responsibility to provide care as primary care providers, on which we established a mediation model. The mediation analysis revealed that normative commitment could positively affect the other four dimensions of organizational commitment and job satisfaction. The direct effect of affective commitment on job satisfaction was significant (LLCI = 0.11, ULCI = 0.31), and the mediators were identified to have a partial mediating effect instead of a total mediating effect. Conclusion: After COVID-19 restrictions end, the job satisfaction and organizational commitment of primary care providers will return to levels before the pandemic and during this estimated process, a brief rise in resignation is predictable. The normative commitment positively affects the other four dimensions of organizational commitment and job satisfaction for primary care providers, which suggests a possible way to motivate primary care providers when restrictions end.

Stigma and Intentions to Seek Psychotherapy Among Primary Care Providers During the COVID-19 Pandemic: A Mediational Analysis.

BACKGROUND: Medical personnel have reported increases in psychological distress and depression during the COVID-19 pandemic. Additionally, many providers, including primary care providers (PCPs), face significant stigma related to personal mental healthcare. However, the process by which stigma affects help-seeking among PCPs is unclear. METHOD: Between January and May 2020, 112 PCPs completed a survey of perceived public stigma, self-stigma, attitudes, intentions to seek psychotherapy for depression, and a clinical vignette on patient referrals to psychotherapy. RESULTS: Self-stigma and attitudes toward psychotherapy sequentially mediated the relationship between perceived public stigma and intentions to seek psychotherapy. PCPs were more likely to refer a depressed patient to psychotherapy than seek personal psychotherapy, but lower personal help-seeking intentions were associated with lower referral intentions. CONCLUSION: These results clarify processes by which stigma hinders PCPs' psychotherapy use and highlight interventions to encourage their help-seeking. Addressing cultural and practical barriers in the medical field is needed to reduce stigma.

Evaluation of electronic recruitment efforts of primary care providers as research subjects during the COVID-19 pandemic.

BACKGROUND: Recruiting healthcare providers as research subjects often rely on in-person recruitment strategies. Little is known about recruiting provider participants via electronic recruitment methods. In this study, conducted during the COVID-19 pandemic, we describe and evaluate a primarily electronic approach to recruiting primary care providers (PCPs) as subjects in a pragmatic randomized controlled trial (RCT) of a decision support intervention. METHODS: We adapted an existing framework for healthcare provider research recruitment, employing an electronic consent form and a mix of brief synchronous video presentations, email, and phone calls to recruit PCPs into the RCT. To evaluate the success of each electronic strategy, we estimated the number of consented PCPs associated with each strategy, the number of days to recruit each PCP and recruitment costs. RESULTS: We recruited 45 of 63 eligible PCPs practicing at ten primary care clinic locations over 55 days. On average, it took 17 business days to recruit a PCP (range 0-48) and required three attempts (range 1-7). Email communication from the clinic leaders led to the most successful recruitments, followed by brief synchronous video presentations at regularly scheduled clinic meetings. We spent approximately $89 per recruited PCP. We faced challenges of low email responsiveness and limited opportunities to forge relationships. CONCLUSION: PCPs can be efficiently recruited at low costs as research subjects using primarily electronic communications, even during a time of high workload and stress. Electronic peer leader outreach and synchronous video presentations may be particularly useful recruitment strategies. TRIAL REGISTRATION: ClinicalTrials.gov , NCT04295135 . Registered 04 March 2020.

Associations among eHealth literacy, social support, individual resilience, and emotional status in primary care providers during the outbreak of the SARS-CoV-2 Delta variant.

Objective: This study aimed to investigate eHealth literacy among primary care providers (PCPs) and explore its association with social support, individual resilience, anxiety, and depression during an outbreak of the SARS-CoV-2 Delta variant in Guangzhou, China. Methods: A cross-sectional web-based survey was conducted in 18 community healthcare centers in Guangzhou, China. The responses of 600 PCPs were tagged as valid responses. Information pertaining to their background, eHealth literacy, anxiety, depression levels, social support, and individual resilience was also collected. Multilevel analysis was used to determine the association among the measures to account for the nested random effect of community health centers in different districts. Results: Participants showed a moderate self-perceived level of eHealth literacy (M = 30, SD = 5.8). Participants who reported higher levels of eHealth literacy were more likely to exhibit lower levels of anxiety and depression, higher social support, and greater resilience. After adjusting for background characteristics, the results of the multilevel logistic analysis showed that eHealth literacy was significantly associated with anxiety and depression, social support, and individual resilience. Younger participants and those who were highly educated reported enhanced eHealth literacy. Conclusions: This study presents a baseline reference for eHealth literacy among Chinese PCPs. Improving their ability to search for and use reliable web-based information was beneficial for facilitating perceived social support and raising resilience during the pandemic. Strategies to provide high-quality web-based information to PCPs to self-assess and identify psychological distress at an early stage should be encouraged.

Pediatric bullying and victimization: Quality improvement project in a primary care setting

Bullying is a form of aggression characterized by repeated psychological or physical oppression, which negatively impacts children. More recently, the phenomenon of cyberbullying, or electronic bullying, has become prevalent. Despite efforts by schools to address forms of bullying, young people continue to be victimized. Primary care settings are well placed to address these issues with patients and their families to improve care and outcomes. Screenings and mental health referrals by physicians have been shown to reduce future involvement in bullying and increase access to treatment. When thinking about healthcare improvements in primary care settings, screening has been shown to be useful for addressing concerns that might not have otherwise come up. Prior to the current study, young adolescent patients were going to be screened for bullying during well-child visits and invited for follow-up. Due to the changes in primary care practice caused by the response to the global COVID-19 pandemic, well-child visits were canceled, requiring that the focus of the study be to explore physicians' perspectives. The current study aimed to explore physicians' attitudes and beliefs regarding bullying through a qualitative approach with the use of semi-structured individual interviews with primary care providers from one practice. Thematic analysis was conducted. The results yielded providers' impressions and beliefs about screening for bullying, indicating the utility of screening as a successful tool to gather more information on adolescent victimization to help patients and families address these concerns. Implications, limitations, and future research ideas are also explored. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Educational Interventions to Support Primary Care Provider Performance of Diagnostic Skin Cancer Examinations: A Systematic Literature Review.

To our knowledge, there is no available standardized educational curriculum designed to promote the incorporation of skin cancer examinations and procedures into general practice. To explore the contemporary training landscape, we conducted a systematic review of educational interventions designed to support skin cancer diagnostic examinations by primary care providers (PCPs). Our review uniquely encompasses all PCPs, including practicing physicians, residents, and advanced practice practitioners (APPs). The objective of this study is to review and synthesize worldwide data on educational interventions addressing PCP performance of skin cancer diagnostic examinations. A systematic review was performed in MEDLINE, Cochrane, EMBASE, and Scopus for English language articles worldwide published from 2000 onwards. Articles were screened for eligibility, and possibly overlapping datasets were resolved. Data extracted included curriculum content, delivery format, and educational outcomes. This review followed the PRISMA guidelines. A total of 63 studies were selected for data inclusion with one addressing training for resident physicians, 4 for APPs, and the remainder for practicing physicians. Educational interventions included in this review reflect the pre-SARS-CoV-2 pandemic educational environment: half provided live/synchronous instruction of about 5-h duration on average, and a quarter featured interactive components. Less than a quarter of interventions included practice change as a specific reported outcome. Without sustainable practice change, the anticipated long-term benefits of early cancer detection in patients remain limited. Previous and existing educational interventions designed to support skin cancer detection by PCPs demonstrate heterogeneous curriculum content, delivery methods, and educational outcomes. An ideal intervention would teach consensus-derived clinical competencies, provide meaningful learner feedback, and measure outcomes, such as knowledge/competency, confidence/attitudes, and practice change, using validated instruments.